Fracture appliance



March 13, 1934.

C. P. JONES FRACTURE APPLIANCE Filed April l5. 1933 y /If I IH,

A TTORNE YS.

atented Mar. 13, 19134 Nr retos l. laim.

My invention relates, in general, to surgical appliances; and, inparticular, to devices for holding the ends of fractured bones togetherwithout motion until new bone has formed.

In common practise, the types of fracture appliances for this purposeare characterized either first by a plate which lies directly upon thebone and spans the fracture, the ends` of the plate being secured byscrews, pins or other penetrating projections which go deeply into thebone on each side of the fracture; o-r second by a band directly uponand tightly encircling the fracture.

In cases where no infection is present, the use of the plate type withits bone-penetrating projections is not necessarily harmful, sinceproper healing may take place, the new bone covering the plate, whichthus becomes a part of the bone. But cases of open or compound.fractures, there is always infection, and it seems poor technique tohave screws or foreign parts going into the substance of the bone, asevery new hole carries the infection into the bone.

Again, where in treating broken limbs say, for example, a fracturedfemur, by means of surgical splints, traction is applied by weights orother devices, the traction pull or drag falls upon the bone penetratingscrews of the plate, thus tending to cause a necrosis of bone over thescrews.

in cases where the band type is used in a transverse fracture, thecallous formation covers the band entirely around the bone, andfrequently such formation must be removed, a hard and long task.

Another fact, to which attention may be called is that if a transplat isused, that is, removing a piece of vbone with double circular saws, andtaking the same sized piece of fresh bone from another bcne, it isnecessary for success to hold the new piece in place firmly. This iscommonly done by boring holes near the edge of the inlay and also nearthe edges of the bone itself. This practise as well as that in which thecommon types of fracture appliances above mentioned are used, muetinevitably lead to the recognition that in bone surgery t e success ofan operation on bones depends upon the smallest amount of handling orbruising of parts.

It is, therefore, the object of my invention, to provide an appliancefrom the use of which such success will follow; and to this end :ityinvention may be briefly stated to consist of a plate devoid of all bonepenetrating projections, whether screws, pins or other impaling members,said plate being adapted to lie upon the bone, overlapping the fracture;and carrying at each end a band for embracing the bone on each side ofthe fracture with means for locking the bands in tight em-r brasure, allas will hereinafter fuly appear, to# gether with details ofconstruction, it being understood that changes may be made withoutdeparting from the spirit of the invention as defined in the claimhereunto appended.

In the drawing, herewith accompanying,

Fig. l is a top plan view of the appliance showing a simple form of theplate and band assembly; v Fig. 2 is a section on the line 2-2 of Fig.1'; Fig. 3 is a top plan view showing a modified assemblage; and Fig. 4is a section on the line 4-4 of Fig. 3.

1 is a plate, in practise, of metal, withsuitable rigidity andcross-section, and of a length adapting it to lie upon the bone and tospan the fracture with sufficient overlap to enable it to be securelyfastened. 2 are the fastening members, consisting of piiant metal ofsuitable cross section, and of a length adapting them to embrace thebone with sufficient surplus to provide for readily tightening andlocking them in their embrasure. In the present case they are shown asflat strips to which the term bands may be and is herein applied; but itis not intended to limit their cross sectional shape to this form,although in many respects it may be preferable. The manner of and meansfor mounting the bands 2 on the plate 1, though possibly varied ormodified in detail must comprise what may be regarded as threeessentials, rst, resistance to pulling stress to tighten them, secondholding them to and guiding them on the plate while being pulled, and,third, locking them at the limit of pull. To these may be added, as willpresently appear, the specific location of the guiding means in order toenable the tightening pull to be applied to the best advantage. Thesimplest form of the appliance is illustrated in Figs. l and 2. Thereare two bands 2, one near each end of the plate 1. One end of each bandis secured, as by a screw 3 to the plate, and the other end is passedthrough and slidably guided in an aperture 4 of the plate, and said endafter passing therethrough is long enough to be pulled upon, andsuitably locked, 10o as, for example, by being doubled down upon itself,as shown at 5.

The application of the appliance to the fracture will now be readilyunderstood. The plate l is laid directly upon the bone, which it tsclosely, and spans the fracture with sufficient clearance of each sidethereof for assuring firm connection. The bands 2 are then by means of aproper gripping instrument, unnecessary to show, passed around under thebone and through the k apertures 4 of the plate 1 which are shaped for arelatively snug band t, and after being pulled tight, said ends arelocked in any suitable manner, such, for example, as being doubled downupon themselves at 5, thus insuring their tight embrasure and holdingthe plate securely and immovably to the bone. Though the apertures 4 inthe plate may be variously located, it is to be especially noted thattheir best position is as here shown through the thickness thereof, sothat they are perpendicular to the upper and lower plate faces, wherebythe band ends pass upwardly through them, thereby projecting above thebone which is the best position to exert the pull to tighten the bands.

Referring now to Figs. 3 and 4, I have shown a further development ofthe appliance in providing for a change of position of the bands 2 alongthe length of the plate 1, as may in some instances be of advantage, andalso, if desired, using' more than two bands, in order that one or moreextra bands' may be placed in the immediate vicinity of and even overthe fracture.

The change of position of the bands along the length of the platerequires, for convenience, that 'said bands be not permanently securedor pinned to the plate as heretofore indicated at 3 in Figs. 1 and 2.Accordingly I have shown in Figs. 3 and 4 that said bands may be readilyremovable for changing their positions, by providing both sides of theplates at intervals with apertures such as 4, and locking both ends ofthe bands by doubling them down as at 5. This will enable the same plateto be used with two or more bands. It is to be noted that the plate 1 iswholly devoid of bonepeiietrating members or projections such as sharppins, or screws, since it is the intention to secure it to the bone onlyby means of the bands. It may be stated at this point that the holesshown at 6 at each end of the plate 1 are retained solely as aprecaution in case screws are needed. All such bone-penetrating devicesare wholly omitted, full immobility being secured solely by thebone-embracing members.

The outstanding advantage in this is the avoidance of infection if suchbe not initially present; or the successful use of the appliance, evenin cases of compound fractures, Where infection is present. Furthermore,where broken limbs are treated by splints anchored to the limb above andbelow the fracture, and in which treatment traction isapplied, thetraction stress instead of being directly and injuriously borne by pinsor screws penetrating the bone, is carried by the bone itself throughthe bands 2, thereby avoiding the danger of infection, as hereinabovementioned.

I claim:-

A fracture appliance comprising a plate devoid of bone penetratingprojections and adapted to lie upon the bone in overlapping spanningrelation to the fracture, said plate having a plurality of spaced guideapertures in its overlapping ends; circumferentially adjustable iiexiblebands independent of said plate for embracing the bone, said bandsslidably passing through the guide apertures of the plate adapting themto be pulled to a tight embrasure of the bone; and means for lockingsaid bands in said embrasure to hold the plate tightly to the bone.

CARL P. JONES.

